Eosinophilic Esophagitis : Treatment and Management
Treating Eosinophilic Esophagitis
The most effective treatment of Eosinophilic Esophagitis involves changes to the child’s diet and nutrition. If your child is diagnosed with EoE, the doctor or medical team will work to identify which foods are causing the condition so that your child can avoid them.
The most common allergic foods include milk, eggs, nuts, beef, wheat, fish, shellfish, corn and soy, but many other foods may also be a factor in EoE.
Some children with EoE may be allergic to a single food, while others may be allergic to many foods.
Because allergy tests are often unable to determine which foods are causing you’re your child may need to temporarily eliminate some or all normal foods from his or her diet, and gradually re-introduce them. If that’s the case, your child may need to temporarily follow an elimination diet or an elemental diet:
Elimination Diet: This type of diet removes all foods that are known to cause an allergic reaction, as well as other foods that are suspected to cause problems. The remaining foods are monitored to ensure a balanced diet
Elemental Diet: This diet removes all sources of protein and introduces a formula made up of amino acids, fats, vitamins, minerals and sugar. Children are often placed on an elemental diet, while adults tend to supplement with other foods. In some cases tube feedings (enteral support) are necessary for growth and weight gain.
If your child improves after following an elimination or elemental diet for a few months, foods will slowly be reintroduced one at a time. Your doctor will monitor your child to make sure he or she can tolerate each food. It’s possible that your doctor will need to perform another endoscopy with biopsy to determine whether your child is responding well to the reintroduced foods.
TIGER is currently in the process of understanding and developing various interventions and treatment approaches for patients diagnosed with EoE.
Currently, medication does not appear to be as effective as dietary changes in the treatment of Eosinophilic Esophagitis. Certain medications, such as pump inhibitors, oral and topical corticosteroids, and leukotriene inhibitors have been shown to have some helpful effects on patients with EoE, but dietary modifications are the primary course of treatment. The health care community is working to identify medications that may be used in the future to treat this condition.